Provider Demographics
NPI:1417732249
Name:GAFF, SHARON KAYE
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:KAYE
Last Name:GAFF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3963 GUSSIE CT
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:IN
Mailing Address - Zip Code:46582-1301
Mailing Address - Country:US
Mailing Address - Phone:574-306-6656
Mailing Address - Fax:
Practice Address - Street 1:3963 GUSSIE CT
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:IN
Practice Address - Zip Code:46582-1301
Practice Address - Country:US
Practice Address - Phone:574-206-6656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28050799A163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management